一台引起放射性皮肤损伤的介入放射学设备检测结果调查与分析  

Investigation and analysis of the testing results of interventional radiology equipment causing radiation skin injury

作　　者：张冰洁 王建伟 毛喻萱 贾天合 王轩 刘彤桢 徐辉[2] 岳保荣[2] Zhang Bingjie;Wang Jianwei;Mao Yuxuan;Jia Tianhe;Wang Xuan;Liu Tongzhen;Xu hui;Yue Baorong(Prevention and Treatment Center for Occupational Disease of Xinxiang City,Xinxiang 453003,China;Key Laboratory of Radiological Protection and Nuclear Emergency,China CDC,WHO Collaborating Centre for Radiation and Health,National Institute for Radiological Protection,Chinese Center for Disease Control and Prevention,Beijing 100088,China)

机构地区：[1]新乡市职业病防治研究所,新乡453003 [2]中国疾病预防控制中心辐射防护与核安全医学所,辐射防护与核应急中国疾病预防控制中心重点实验室,世界卫生组织辐射与健康合作中心,北京100088

出　　处：《中华放射医学与防护杂志》2024年第4期292-297,共6页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的通过调查和分析一台引起放射性皮肤损伤的介入放射学设备的质量控制检测结果,为介入放射学程序运行过程中的放射防护最优化提供建议。方法调取一台引起患者放射性皮肤损伤的介入放射学设备近3年的5次质量控制检测报告,比较检测结果的差异并分析存在的问题。结果对于"透视受检者入射体表空气比释动能率典型值"项目,3家机构5次检测结果在6.08~24.89 mGy/min之间,符合相关标准的要求;不同曝光模式(普通剂量率透视模式、高剂量率透视模式、电影模式)和不同帧率对受检者入射体表空气比释动能率和透视防护区检测平面上周围剂量当量率检测结果影响较大;操作该设备的介入医生对设备的曝光模式了解不足,手术后未记录患者剂量。结论通过对介入放射学设备的调试可显著降低患者剂量;建议在标准修订时增加参考点累积剂量或剂量面积乘积准确性指标的检测;加强对介入医生和技师的专业培训,使其充分了解设备不同曝光模式对患者和术者剂量的影响。Objective To provide suggestions for the optimization of radiation protection during interventional radiology procedures on the basis of investigate the quality control testing result of an interventional radiology equipment that has caused radiation skin damage.Methods Five quality control testing reports on an interventional radiology device that has caused radiation skin injury to a patient in the past three years were selected to compare the differences between the testing results and analyze the existing problems.Results For the program of"Typical value of entrance surface air kerma in fluoroscopy mode",the testing result from the three institutions were in the range of 6.08-24.89 mGy/min,which met the requirements of relevant standards.The testing result of both the entrance surface air kerma and the ambient dose equivalent rate on the area of the operators differs greatly dependent on different exposure modes(normal fluoroscopic dose rates mode,high fluoroscopic dose rates mode,and cine mode)and different frame rates.The interventional operators for the device were lack of understanding of the influence on exposure modes,and patient doses were not recorded after an interventional surgery.Conclusions The patient dose can be significantly reduced by adjusting an interventional radiology equipment.It is recommended to increase the testing of reference point cumulative air kerma or dose-area product in future standard revisions and strengthen professional training for interventional operators and technicians,so that they can fully understand the differences in the effect of exposure mode of a interventional radiology equipment on patient and operator dose.

关 键 词：放射性皮肤损伤 介入放射学 放射防护检测 

分 类 号：R143[医药卫生—公共卫生与预防医学]